Coadministration of these two medications confers excess risk for sudden death.
Researchers in Canada previously demonstrated that patients who are taking both trimethoprim-sulfamethoxazole (TMP/SMX) and spironolactone are at excess risk for being hospitalized with hyperkalemia (NEJM JW Gen Med Nov 1 2011 and BMJ 2011; 343:d5228). Now, the same team has performed a population-based case-control study in Ontario to determine whether this interaction might confer risk for sudden death, which can be triggered by hyperkalemia.
During an 18-year period, 349 patients (age, ≥66) died suddenly while taking both spironolactone and one of five antibiotics (TMP/SMX, amoxicillin, ciprofloxacin, norfloxacin, or nitrofurantoin). Each case was matched with as many as four age- and sex-matched controls who took spironolactone plus one …
Reviewing Author
DisclosuresNothing to disclose
DisclosuresNothing to disclose